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O elbow

notes from lecture

TermDefinition
humeroulnar flex & ext. ulna connects w/troclea
humeroradial pronation & supination. radial head spins on capitulum. radius surface is concave also
radioulnar pronation & supination
what moves during pronation and supination? radius/ ulna does NOT move
carrying angle bc medial surface ext farther distally, in ext the elbow is in valgus position of 10-15 degrees
ligaments of elbow medial (ulnar) collateral, lateral (radial) collateral, annular (holds radial head to ulna @ radial notch)
elbow end feel in ext bony
elbow end feel in flex soft tissue
elbow end feel in pronation & supination ligamentous
brachialis OIAN O:distal 1/2 of humerus, ant surface. I:coronoid process & ulnar tuberosity of ulna. A:elbow flex. N:musculocutaneous
biceps OIAN O:long head:supraglenoid tubercle of scap. short head:coracoid process of scap. I:radial tuberosity of radius A:elbow flex, forearm sup N:musculocutaneous
brachioradialis OIAN o:lat supracondylar ridge on the humerus. I:styloid process of the radius A:elbow flex N:radial
triceps OIAN O:long head:infraglenoid tubercle of scap. lat head:inferior to greater tubercle on post humerus. Medial head:post surface of humerus. I:olcranon process of ulna. A:elbow ext N:radial
supinator OIAN O:lat epicondyle of humerus & adjacent ulna. I:ant surface of the proximal radius. A:forearm supination N:radial
pronator teres OIAN O:medial epicondyle of humerus & coranoid process of ulna. I:lat aspect of radius @ its midpoint A:forearm pronation, assist in elbow flex N:median
pronator quad OIAN o:distal 1/4 of ulna. I: distal 1/4 of radius. A:forearm pronation. N:median
most common elbow fx fx of head of radius-often head will dislocate and needs ORIF
elbow fx rx pt in splint for 3-5 days which is removed for PROM, AROM, isometrics. over next 2-6 wks progress to strengthening & stretching w/goal to return to activity in 6 wks
another common elbow fx supracondylar
severe complication to supracondylar fx Volkmans Ischemic contracture
Volkmans Ischemic contracture cause obstruction to the brachial artery & venous return due to bone displacement or vascular damage. if not restored will get mm fibrosis. wrist flexors contracted
early signs of Volkmans Ischemic contracture cyanosis, loss of radial pulse, sensory loss, severe forearm pn esp w/mvmnt
Volkmans Ischemic contracture rx elevation, ROM & splinting, stretching when appropriate. paralysis is permanent but if caught early can be managed medically
overuse syndromes:repetitive trauma syndromes lat elbow tendonopathy (tennis elbow), medial elbow tendinopathy (golfer's elbow)
lateral epicondylitis microtrauma of wrist ext mechanism esp extensor carpi radialis brevis. brevis is most commonly injured bc when elbow is ext & wrist is flexed, brevis rolls over radial head. chronic inflammation develops
lateral epicondylitis S&S local tenderness, pn, edema over common extensor area that increases w/activity or stretching. may be referred pn into arm. can be work related (typing, power tools) or recreational (back hand, piano)
lateral epicondylitis acute rx RICE, gentle PROM/AROM in painfree range, modalities such as Estim, US or massage, ionto, phono, immobilization in brace, cock up splint
lateral epicondylitis subacute rx AROM. cont to rest is real key
lateral epicondylitis chronic rx teach pt self stretch, isometrics & progress to strengthening using theraband or wt to both agonist & antagonist & pronators & supinators. asses mechanism of injury & look for correction or prophylaxis. gradual return to activity
medial epicondylitis also overuse of wrist flex (FCR, FCU, FCS) cause by improper golfing technique, gripping tools
medial epicondylitis acute rx RICE, gentle PROM/AROM in painfree range, modalities such as Estim, US or massage, ionto, phono, immobilization in brace, cock up splint
medial epicondylitis subacute rx AROM. cont to rest is real key
medial epicondylitis chronic rx teach pt self stretch, isometrics & progress to strengthening using theraband or wt to both agonist & antagonist & pronators & supinators. asses mechanism of injury & look for correction or prophylaxis. gradual return to activity
PNI ulnar sensory loss of ulnar hand, little finger, ulnar 1/2 of ring finger-wkness of ulnar 1/2 FDP & FCU, hypothenar mm, interossei, 3,4 lumbricals, FPB, add pl
PNI radial wk wrist & finger ext, supinator- sensation loss dorsum of hand & radial side of 3rd metacarpal, dorsum of thumb & 1st 2 fingers
periperal neuropathy median wkness of pronator teres, wrist flexors, extrinsic finger flexors, thenar & lumbricales 1-2- sensory loss is radial palm & palm side of thumb, index & middle finger
olecranon bursitis caused by pressure (leaning on elbows) sometimes aspiration needed
total elbow not common. indicated by severe arthritis, gross instability. result is not full range or strength. maybe 90 degrees
Created by: jessigirrl4